4 Cooperative Education Time / Wage Report
Download a Word Document file of this report here.
COOPERATIVE EDUCATION
TIME/WAGE REPORT
In order for a co-op student to receive academic credit, an account of time and days worked on the job must be recorded by the student and verified by the supervisor. This information will be kept confidential.
Student name:_____________________________ Employer __________________________________
Month__________________ Year___________________
| Weeks | S | M | T | W | TH | F | S | Total hours |
| Monthly Total |
Summary of monthly tasks performed:_____________________________________________________
____________________________________________________________________________________
I certify that the above time report is a true statement I certify that the above time report is a true
of the hours worked this week statement of the hours worked this month.
__________________________________________ ______________________________________
Student Signature Date Employer Signature Date
Month_________________________________ Year__________________
| Weeks | S | M | T | W | TH | F | S | Total hours |
| Monthly Total |
Summary of monthly tasks performed:_____________________________________________________
____________________________________________________________________________________I certify that the above time report is a true statement I certify that the above time report is a true of the hours worked this month. statement of the hours worked this month.
_________________________________________ ______________________________________
Student Signature Date Employer Signature Date
Student name:_____________________________ Employer __________________________________
Month__________________ Year___________________
| Weeks | S | M | T | W | TH | F | S | Total hours |
| Monthly Total |
Summary of monthly tasks performed:_____________________________________________________
____________________________________________________________________________________
I certify that the above time report is a true statement I certify that the above time report is a true
of the hours worked this week statement of the hours worked this month.
__________________________________________ ______________________________________
Student Signature Date Employer Signature Date
Month_________________________________ Year__________________
| Weeks | S | M | T | W | TH | F | S | Total hours |
| Monthly Total |
Summary of monthly tasks performed:_____________________________________________________
____________________________________________________________________________________I certify that the above time report is a true statement I certify that the above time report is a true of the hours worked this month. statement of the hours worked this month.
_________________________________________ ______________________________________
Student Signature Date Employer Signature Date
